ID: 2014-03-81-A-3831

Original article (free structure)

Shcherbakova I.V.

Summary

The main goal of the development of the system of medical education at the present stage is the formation of a specialist who is ready for independent medical practice in the conditions of the modern level of material and technical equipment of healthcare. To achieve this goal, a significant material and technical re-equipment of the industry is expected: the creation of training centers on the basis of educational and medical institutions, the organization of high-tech medical care centers, educational and labor activities in which are possible only if thorough training in the disciplines of the natural science cycle in the process of studying at a medical university . In this regard, the personal-value aspect of education acquires fundamental meaning. In the process of teaching physics, mathematics, and computer science to students of a medical university, innovative technologies should be used.

Keywords

Medical education, medical university, motivation, student adaptation, medical statistics

Article

The main methodological component of the third generation GEF is the competency-based approach, according to which the formation of a specialist ready for independent medical practice in the conditions of the modern level of material and technical equipment of healthcare is put forward as the main goal of the development of the medical education system. To achieve this goal, a significant material and technical re-equipment of the industry is expected: the creation of training centers on the basis of educational and medical institutions, the organization of high-tech medical care centers. However, high-quality educational and labor activity in these centers is impossible without thorough training in the disciplines of the natural science cycle in the process of studying at a medical university.

These circumstances determine the relevance of the study of the problem of professional adaptation of first-year students of a medical university.

The purpose of this work is to study a number of aspects of the problem of professional adaptation of first-year students of a medical university.

To achieve this goal, the work is supposed to solve the following main tasks: to analyze the role of natural sciences in the system of medical education; to identify the role of courses in physics and medical statistics in the system of teaching first-year students of a medical university; to determine the directions of increasing the subjectivity of their education.

First of all, it should be noted that a high level of adaptation of a graduate of a medical university in the workplace can only be ensured on the basis of high-quality training in all areas, developed logic of thinking and the ability to apply the acquired knowledge in practice. The requirements for natural science training are specifically stipulated in the documents that define the qualification characteristics of a modern doctor. This is due to the promotion of the latest achievements of the natural sciences, which are of general scientific importance, to the system of medical education, contributing to the formation of a holistic worldview and a natural-science style of thinking among future doctors, which will improve the quality of their fundamental training. It can be argued that the current stage of development of society is characterized by a qualitative change in the activities of a doctor, which is associated with the widespread introduction into this activity of procedures for mathematical modeling of phenomena that take place in medical practice.

In this regard, speaking about the problem of adaptation of students of a medical university, it should be noted the huge role of the basic courses of natural-mathematical and medical-biological disciplines - such as chemistry, biology, physiology, physics, higher mathematics, computer science. Natural science knowledge largely determines the capabilities and degree of readiness of a specialist in the development of private medical techniques, new medical technologies. The high rate of renewal of natural science knowledge necessitates not only their study, but also their effective application, and this, in turn, requires training in the ability of future specialists to learn in the course of their professional activities, and a significant role in solving this problem belongs to pedagogical science in the system of higher medical education. education.

Given the need to master the skills of working with complex electronic devices, in terms of adaptation of medical students, priority should be given to teaching physics. The importance of physics for modern medicine cannot be overestimated. Physical methods of influence (fields, ultrasound, elementary particles) and physical methods of analysis (electron microscopy, registration of biopotentials, the use of radioactive isotopes) began to be widely introduced into all sciences of the natural cycle. Biophysics has developed - a science that studies the effect of physical factors on living organisms. From it grew medical biophysics, the purpose of which is to create the foundation of practical medicine, to establish a strong connection between medicine and the exact sciences. For example, mathematics is the basis for modeling physical, chemical, biological processes, it is necessary both for processing statistical data in the course of monitoring patients and compiling reports, and for the scientific work of a doctor.

However, in recent years there has been hostility, and often rejection by first-year students of classes in physics and mathematics. As the main factor complicating the adaptation of students of a medical university, experts point out a significant degree of isolation of the content and forms of the traditional course of study from the age and personal needs of students. Using the terminology of behaviorism, we can say that the "reinforcement value" for this course is very low, and even that is external (test and exam). Medical and biological physics in a medical university, as a rule, is not perceived by students as a "pre-profile" discipline. They do not see the value-semantic aspects of its study, ways to further use the knowledge acquired in the study of physics and mathematics in specialized disciplines. The learning process is not perceived by students as a holistic one, between the components of which there are successive links. In addition, every year there is an increasing shortage of time allotted for studying the huge amount of content of educational material in physics, mathematics, computer science, included in the course of medical and biological physics.

In this regard, it seems relevant to comprehend the conceptual foundations of the methodology of teaching physics, mathematics and computer science in a medical university based on literature data and generalization of 20 years of experience of the Department of Medical Biophysics of the Saratov State Medical University named after V.I. Razumovsky (SSMU).

First of all, it should be noted that high-quality assimilation by students of the material of the course of medical biophysics is possible only with a high level of intrinsic motivation - it can be achieved on the basis of an interactive approach. The main feature of the interactive approach is its dialogic character. This allows you to increase the subjectivity of learning, make the student a full-fledged interlocutor and a full participant in the learning process at the university.

In the conditions of traditional education, the teacher learns about how his monologue is perceived only at the test or exam. Obviously, the teacher lacks "feedback" in the conditions of monologue educational communication. But in order to achieve modern learning goals, the teacher must be ready for a spontaneous dialogue, and moreover, to initiate its occurrence. Only in this case will the solution of the problem of increasing the subjectivity of learning be achieved, when students move from a passive role in the educational process to an active one.

However, the condition of dialogicity alone is clearly not enough for the formation of internal learning motivation. Qualitative assimilation of educational material is possible only if its content is correlated with the personality of the student. The student must "see" the material not as something abstract in relation to him, but as something that directly concerns him and affects him, is connected with him, his life, his professional future. He should have the opportunity to "recognize" himself in those laws, rules, theories, examples, etc., which are taught to him. Such "recognition" allows the student to really assimilate the educational material as something essentially close and related, in other words, to make it a part of himself. If this does not happen, then there is a rejection of the educational material as something foreign, and the student safely forgets it after passing the exam or test. The latter is a completely normal reaction of the human psyche.

These reasons necessitate the search for ways of motivation, new approaches, methods, didactic teaching aids that reveal cognitive and semantic values ​​that orient students to use the knowledge of the course of medical and biological physics in specialized disciplines. Only in this case will a basis be created for increasing the level of adaptation of first-year students of a medical university.

It seems that in a lecture course on physics, time should be allocated in order to unfold to students the general logic of the development of scientific and engineering thought and the progress of information processing in medical systems. First-year students should learn that physical laws underlie radiation biophysics and ecology, various types of diagnostics, cryobiophysics, medical tomography and imaging.

Students will undoubtedly be interested in lectures on pseudo-three-dimensional images of a deep tumor with color highlighting of the vessels feeding it or on the prognosis of the development of a pathological process of unclear etiology. In practical classes, students can work out the skills of students as users of existing computer programs in medicine, conduct presentations prepared by the students themselves.

Mastering biophysical, biochemical and environmental research methods, using computers in biology and medicine, students get the opportunity to conduct system analysis and develop mathematical computer and laboratory models of specific physical and technological processes for medicine, apply mathematical methods for processing medical images of x-ray, magnetic resonance and ultrasound tomography and other types of medical diagnostics.

One of the most important disciplines studied in medical schools in the last decade is medical statistics. Its development is not only in accordance with the traditions of this discipline, but also in close interaction with the development and achievements of mathematical statistics and information technology. Knowledge of medical statistics and experience in its use are necessary for every doctor in medical research.

However, the development of medical statistics by first-year students is still poorly motivated. Underestimation of the role of this subject on the part of students is due to the fact that, while studying in the first year, they do not sufficiently represent the areas of application of mathematical statistics in medicine and, as a result, are little interested in mastering the material being studied. The main drawback of the available educational literature on mathematics and statistics is that it presents an insufficient number of tasks of biological, physiological, medical content that are adequate to the level of first-year knowledge. Most often, such literature presents problems traditionally associated with the throwing of coins, dice, at best, with the distribution of the height of schoolchildren or the weight of babies; sometimes you can meet tasks about changing the activity of tetracycline or the content of leukocytes in the blood, which corresponds to the knowledge of older students and requires additional thought. This problem worries experts, but so far its solution has not been found.

In this regard, the level of knowledge of students of a medical university - both in the field of various statistical methods, and in the field of skills for their adequate use - remains low. It seems necessary to place the main emphasis in teaching this subject on the practical use of statistical methods in solving problems close to medical research and practical work of students. The presentation of methods of mathematical statistical analysis should be combined with consideration and recommendations in the field of using modern office programs. More study time should be allocated to the study of this subject as part of the disciplines taught at the Department of Medical Biophysics. In this case, first-year students of a medical university will be able to acquire the basic knowledge necessary for compiling reports on preventive and curative work, preparing certification materials for assigning a qualification category.

The use of statistics is necessary because in these materials it is required to indicate morbidity estimates by nosological forms, the number of consulted and treated patients for a certain period of time, the number of patients who have completed rehabilitation courses, to represent the ratio of those who applied to the doctor and treated patients, to subdivide them by age and gender. Comparison reports typically use absolute values ​​(number of patients treated in a polyclinic or hospital) as well as point estimates, often using confidence intervals, in accordance with the requirements of health management practice and qualification commissions.

Education should be built as a single, holistic process, focused on the successive links between general education disciplines and profile ones. At the same time, the personal-value aspect of education acquires a fundamental character and meaning. At the forefront are questions of an individual-motivated attitude of a person to his own learning, its level and quality. When teaching physics, mathematics and informatics to students of a medical university, it is important to use innovative technologies, which include didactic teaching aids focused on the implementation of the value-semantic aspects of the material of the studied disciplines.

This will teach freshmen to understand the principles of operation of medical equipment, analysis and management of information flows in medicine; accurately and logically correctly formulate scientific and practical problems; to choose adequate methods and tools for their solution, which will undoubtedly increase the level of their adaptation to effective activities in the field of medicine.

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12. Yusupov R.M., Rudnitsky S.B., Wasserman E.L., Kartashev N.K. Express diagnostics and monitoring of the functional state of a person based on complex processing of biometric data: development of a research polygraphic complex // Fundamental sciences - medicine: Proceedings. report M., 2010.

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D.E. Tsymbal,Doctor of Medical Sciences, Professor of the Department of Health Management, Saratov State Socio-Economic University, Head of the Territorial Body of Roszdravnadzor in the Saratov Region,[email protected] rambler. en

N.G. Korchever, Doctor of Medical Sciences, Professor of the Department of Health Organization, [email protected]

E.V. Zavaleva, postgraduate student of the department healthcare organizations,public health and medical law SBEI HPE "Saratov State Medical University named after I.I. IN AND. Razumovsky" of the Ministry of Health of Russia, ezavaleva@ yandex. en

The article presents the results of a study of the state of managing the adaptation of young doctors to the conditions of independent professional activity, identified shortcomings, substantiated the requirements for optimization technology.

Introduction

Considering that within the framework of the health care modernization program, overseen by Roszdravnadzor, significant measures have been taken in recent years to preserve and develop the personnel potential of the industry, the “struggle” for each graduate of a medical university is very relevant.

Everyday healthcare practice shows that graduates of medical universities in the first years of independent work experience certain difficulties of a professional and socio-psychological nature. At the same time, it is known that the leading role in changes in the state of health, the functional state of the body and the socio-psychological sphere in the process of learning and work belongs to adaptation to new conditions of life. That is why the process of adaptation of young doctors to the conditions of independent professional activity needs purposeful management. However, the analysis of the literature shows that there are not enough publications devoted to this problem.

Objectiveconsists in studying the state of managing the adaptation of graduates of medical universities to the conditions of independent professional activity and determining the directions for its optimization.

Research methods and organization

The work carried out:

The study of data from the reports of the Ministry of Health for 2006-2010, the documentation of sixteen medical institutions (HCI) of the Saratov region and 84 reviews of graduates of the Saratov State Medical University (SSMU) received in 2011;

The study of the results of an anonymous survey on a specially designed questionnaire of 98 medical organizers who underwent advanced training at the Department of Health Organization, Public Health and Medical Law of the SSMU, their professional experience was at least 10 years.

Statistical processing of the obtained research materials was carried out using a personal computer.

Research results

The study of data from the reports of the Ministry of Health of the Saratov Region shows that, although attention is paid to graduates of medical universities, it is often limited to stating the number of dismissed from work for a specific period of time (from 168 to 237 people arrived annually and 13.1% quit on average). The reasons for the dismissal of young doctors and their further fate were not purposefully analyzed.

The medical facility has not developed such an operational planning document as an adaptation program, which involves a comprehensive assessment of the professional and personal qualities of a newly arrived young doctor, systematic recording and monitoring of the results of its implementation, and, if necessary, targeted corrective measures.

At the same time, the young medical replenishment made up individual plans for becoming a position, which, nevertheless, did not take into account the patterns and features of adaptation to the conditions of independent professional activity in a particular health facility. Here, however, there was no structural consolidation of adaptation management functions for persons (persons) from among the management staff - curators of certain departments - and mentoring.

An analysis of the feedback on graduates that were requested by SSMU showed that they were also of a formal nature, stated the fact of arrival from a medical university and, at best, contained a list of rewards for individual graduates (3 out of 84).

Thus, it can be stated that the management of the adaptation of young doctors to the conditions of independent professional activity is not given due attention, and this process needs targeted optimization. The data of the anonymous retrospective survey of medical organizers made it possible to substantiate the requirements for the technology of such optimization. By "technology" in a general sense, it is customary to understand a set of actions that includes methods, procedures, techniques, equipment and other systematically applied tools for solving specific problems.

First of all, adaptation management goals were set. Nine of them were identified as significant - from 6.3 to 5.6 points on a 10-point scale (in descending order of priority):

It is possible to achieve faster performance indicators acceptable for a medical organization;

Reducing start-up costs (as long as a young doctor is less efficient than experienced employees, his work requires higher costs from the organization);

Faster entry into the work team, its informal structure and the feeling of being a member of the team;

Decreased anxiety and insecurity experienced by the new employee;

Reducing staff turnover among young recruits;

Saving the time of the immediate supervisor and colleagues (a doctor who has not sufficiently adapted to work in an organization requires much more time to help in the process of fulfilling his duties);

Formation of a personnel reserve (mentoring over adaptants is an opportunity for an experienced employee to gain leadership experience);

Development of satisfaction with professional activity, a positive attitude towards it and realism in expectations as an indispensable condition for high performance;

Reducing the cost of finding new staff.

Any management process, including adaptation, needs organizational support. Four (also recognized as significant - more than 6.5 points) stages of such provision were identified. The first stage is the initial assessment of the individual psychological qualities of the newly arrived graduate, i.e., the "potential" success of adaptation. The second stage is the development of an adaptation program that takes into account, along with the potential of a young doctor, his current and future business assignment. The third stage is the implementation of the adaptation program, which involves systematic accounting and monitoring of the results of its implementation. The fourth stage is summing up the results of adaptation (by stages and in general). If necessary, the adaptation program is corrected, appropriate corrective measures, dynamic assessment, etc. are carried out.

Respondents proposed a list of activities that should be carried out in order to increase the success of adaptation of young doctors. These activities are aimed at optimizing the object, content, conditions and organization of this process, in particular, increasing the levels of professional preparedness (conducting individual conversations between a manager, a mentor and a new employee, using the method of gradually complicating tasks with simultaneous control and constructive analysis of mistakes made during the performance of tasks, organizing seminars, courses, etc.), positive motivation to perform medical duties, the functional state and resistance of the body (active recreation; general and special physical training; physiological and hygienic means and methods - hardening of the body, etc.; electrophysiological methods - electrical stimulation of the nervous - muscular system, impact on biologically active points, pharmacological and physical means - sauna, massage, etc.); creating a favorable psychological climate in the team (goodwill, support from comrades and management, practical assistance in overcoming difficulties, performing one-time public assignments to establish contacts between a new employee and the team, holding special role-playing games to unite employees and develop group dynamics); implementation of an individual approach, taking into account the individual psychological characteristics of adaptants, the degree of adaptation to the conditions of independent professional activity, for example, individual regulation of activity, etc.

All respondents believed that the orientation of a medical school graduate plays an important role in the adaptation management, which can be conditionally divided into general and special. When organizing a general orientation, it is advisable to familiarize a young doctor with:

wages;

D additional benefits;

- general data on the medical organization (goals, priorities, problems; traditions, norms, standards; variety of types of medical activities, the list of medical services provided and the contingents of their consumers; algorithms for the provision of medical care; organization, structure, communications of health facilities; information about managers);

- the policy of the organization (principles of personnel selection; organization of professional training; working hours, etc.);

- occupational health and safety;

- economic factors (cost of equipment; damage from absenteeism, delays, accidents);

- household service (catering, availability of service entrances, conditions for car parking, etc.);

- terms and conditions of appointment, movement and promotion up the career ladder;

Management of work and methods of its evaluation;

The rights and obligations of the employee and his immediate supervisor;

Relations with the trade union, its influence on the policy of the organization;

discipline and possible penalties;

Channels of communication, the procedure for reporting failures and lateness to work, the dissemination of new ideas, filing complaints.

The components of this stage, arranged in descending order of priority, were also assessed by the respondents on a 10-point scale - from 8.8 to 5.5 points

Respondents similarly ranked and rated items with special orientation of young medical recruits (their significance ranged from 7.7 to 6.2 points):

Familiarization with job duties and responsibilities (detailed description of current work and expected results;

Explanation of the importance of this work, how it compares with others in the unit and in the medical organization as a whole;

Standards for the quality of medical care and the basis for its assessment;

Duration and schedule of the working day;

Additional expectations (for example, replacement of absent staff);

Procedures, rules, regulations (rules specific only to this type of medical care or this unit; behavior in case of possible specific emergency situations);

Informing about accidents and dangers;

hygiene standards;

Security and issues related to theft;

Relations with employees of other departments;

Rules of conduct in the workplace, removal of things from the unit, telephone conversations;

Monitoring violations;

Breaks;

Use of equipment;

- unit functions (goals and priorities, organization and structure; activities; relationships with other units; relationships within the unit);

- required reporting.

In addition, the procedure for introducing employees of the unit acts as a special orientation.

The results of the study, as well as the analysis of the literature, showed that the management of the adaptation of graduates of medical universities to the conditions of independent medical practice should be a set of directive acts of purposeful influence, based on the analysis of personalized information, which makes it possible to identify the corresponding discrepancies - problems. At the same time, it is extremely important to obtain data on the true state of the control object, i.e., the individual potential and dynamic success of the adaptation of a particular graduate of a medical university, which means that it is necessary to develop an appropriate assessment method. It can be designed based on the principles of decision theory and must meet the following requirements:

To be systemic and to evaluate not individual independent indicators, but the functioning of the entire system of individual adaptation, that is, informative criteria should characterize all its stages: afferent synthesis, decision-making, efferent synthesis, reverse afferentation;

Have a clear gradation and a sufficiently detailed description of each informative criterion, for example, its high, medium, low levels;

Separate informative criteria according to the degree of importance in relation to the result of adaptation (system-forming factor) - for each, determine the coefficient of significance;

Carry out a multi-criteria individual assessment based on comparison with reasonable model options (“excellent”, “good”, etc.);

Determine the final integral assessment using a computer program available to an unprepared user;

Allow for a comparative assessment of any number of doctors in the dynamics of their professional development.

An essential advantage of this method is that it allows you to analyze the reasons for obtaining an individual assessment, since it shows by what informative criteria (especially with the maximum value of the significance coefficient) it is set, and to give targeted recommendations for correcting the adaptation process.

Conclusion

Thus, the results of the study showed that the management of the process of adaptation of young doctors needs to be optimized and requires a transition to a modern professional level.

Literature

1. Korshever N.G. O optimization of medical care for the population of the municipal district/ N.G. Korshever, A.V. Grechishnikov. Saratov Military Medical Institute, 2010.

2. Korshever N.G. Reduction of conscription military service to one year: features of adaptation to new conditions of military professional activity / N.G. Korchever, D.A. Sitmbetov. Saratov: Publishing house of SSMU, 2011.

3. Makeeva O.V. Adaptation as a goal and condition for the successful functioning of any economic and social system // Bibliosphere. 2009. №3. pp. 16-23.

4. Medvedev V.I. Interaction of physiological and psychological mechanisms in the process of adaptation // Human Physiology. 1998. V. 24. No. 4. pp. 7−13.

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The contribution of the head of a medical institution to the professional adaptation of medical university graduates

Chizhkova Marina Borisovna

Moskaleva Yulia Anatolievna

annotation

The article deals with the issues of practical implementation of the expectations of interns and residents of the Medical University from the personality and activities of the immediate supervisor from the medical institution in the process of professional adaptation. Based on the analysis of scientific literature and ideas about professional adaptation as a process that mutually satisfies the requirements and expectations of an individual from professional activity, the authors emphasize the relevance of studying the stated problem in medical universities, whose graduates are included in the professional activities of a doctor already at the stage of training in internship and residency, up to began independent work in medical institutions as a certified and certified employee. Based on the questionnaire of the graduate R.V. Gurina, which allows to determine the consistency of the individual's requests with the requirements for a certain activity, the relationship between adaptation and the realization of the individual's expectations, the authors state a significantly low level of implementation of the depth of professional knowledge and methodological skills expected from the personality of the leader, and from the activity - active assistance in mastering the chosen specialty. The generalization of the data obtained in the study gives the authors reason to conclude that the professional adaptation of graduates of the medical university is ambiguous: the demonstrated success of adaptation to professional activities on the basis of medical institutions conflicts with the unsatisfied needs of interns and residents from the personality and activities of the direct supervisor from medical institutions at these stages of vocational education.

Keywords: medical education; medical school graduate; internship; residency; interns; residents; professional adaptation; medical and preventive institution; the identity of the immediate supervisor of the internship / residency; activities of the direct supervisor of the internship / residency; expectations from the personality and activities of the leader; practical implementation of expectations from the personality and activities of the leader

Cardinal transformations in all spheres of social production in Russia have led to a qualitatively new understanding of the process of becoming a specialist's personality, the strengthening of practice-oriented professional education, and the reorientation of the assessment of education results from the "education" model to the "competence" model. The most important trend in improving the quality of higher professional education is focusing on the demands of the labor market, strengthening the interaction of universities with the manufacturing sector, science, the state employment service, culture and other social institutions (R.A. Burganov, M.A. Vakhtina, I.Yu. Zhdankina and E. A. Shamin, T. V. Kondratieva, V. B. Moiseev and L. I. Naydenova, A. V. Timiryasova and T. V. Kramin, E. A. Opfer and others).

However, as noted by a number of authors (N.V. Bondarenko, V.G. Zarubin, E.A. Kuzina, E.A. Opfer, T.B. Pankratova et al., S.M. Salov, I.V. Sokolnik and others), the education sector, which currently has the potential to develop effective cooperation with industry and employers, does not demonstrate flexibility and readiness to form the basis for cooperation and is characterized by a number of contradictions that complicate the employment of young people.

Firstly, there are no prerequisites in education for the transition of young people to the sphere of employment with the necessary level of qualifications and work experience, which hinders the possibility of realizing their potential at the initial stage of labor activity. Since education is in many cases considered as a certain stage for obtaining high incomes and a certain social status, there is a situation of "over-education", the orientation of the majority of young men and women to study in institutions of higher professional education.

Secondly, the supply on the education market is represented mainly by such educational products that are in demand by society in the short term, without correlation with the forecast needs of the labor market and without coordination with long-term prospects within the framework of regional and state development strategies. Moreover, the study of the experience of 35 Russian universities in monitoring the satisfaction of employers with the quality of graduate training demonstrates the presence of this work in many universities, but only some of them adjust the educational process, introduce new training courses and even entire specialties in order to meet graduates with modern market requirements. labor .

Thirdly, against the backdrop of dynamic changes in the conditions of professional activity and production requirements for easily modifiable knowledge, skills and abilities that contribute to the successful adaptation of an employee to world changes in a particular field of activity, there are trends in the higher education system to graduate young professionals that do not meet current and prospective needs of the labor market, their lack of flexibility with changes in the professional and qualification structure of the market.

The resolution of these contradictions should be based on the understanding that production and the employers personifying it (most often, the heads of certain enterprises, organizations, institutions) are not just a category of labor market participants that act as experts on the level and content of graduate training, but also customers, and consumers of educational services of the university. Employers carry out certain functions at each stage of the preparation of the future professional. At the stage of developing a model of a quality educational process, the prognostic function dominates, which consists in updating modern requirements for the competence of graduates as the basis for determining promising areas for improving the level of training of specialists. At the stage of implementation of the educational process, a transformative function is carried out, consisting in the organizational and meaningful participation of employers in the educational process of the university, including the implementation of educational technologies on the basis of practical training, thereby ensuring the professional socialization of specialists. At the final stage, the expert function becomes prevalent, manifesting itself in assessing the quality of training of students and graduates during the period of work experience and the final state certification.

The relevance of the problem of interaction between educational institutions and employers in healthcare is determined not only by the stated shortcomings of professional medical education (inconsistency in the quality of training of specialists with modern requirements, the lack of an integrated system of professional training in the conditions of "university-real clinical practice", the absence of an external quality assessment technology standardized for the tasks of practical healthcare vocational education) [cit. according to: 6, p. 50], but also acute personnel issues of medical institutions (hereinafter referred to as HCI), which determine the quality of medical care and its availability.

Medical personnel is the most significant part of health care resources, providing, along with organizational forms and the state of the material and technical base, the effectiveness and efficiency of the work of the health facility and all its departments. However, choosing the right specialist, corresponding to the vacant position with the level of their professional knowledge, skills, general cultural competencies and personal qualities, is a difficult and sometimes difficult task.

As the results of empirical studies show, the main claim of employers to medical universities today is the excessive "theorizing" of training, the isolation of the acquired knowledge from practice, the inability to handle modern equipment, and psychological unpreparedness for the realities of production. About a third (30.2%) of the heads of healthcare facilities believe that the quality of higher medical education does not meet the requirements for local medical workers, provoking 30-40% of graduates to leave the profession. Among the reasons for the low level of training, leaders see the limited opportunities for students to undergo clinical practice (34.6%), outdated standards for training specialists (20.1%), and the lack and insufficient professionalism of teachers (9.4%). Intern Medical University Head

In our opinion, the explanation of the "staff shortage" in health care facilities solely by gaps in the educational process of a medical university is not entirely legitimate. It is also necessary to take into account the fact that often the chief physicians quite formally approach the organization and conduct of practical training of students, shifting the responsibility for training the future specialist either to the teachers of the supervising departments, or to the head of the department, overloaded with a combination of medical and administrative activities.

Implementing the personnel policy, the head of the healthcare facility needs to actively engage in work to secure potential personnel, form and maintain a workforce capable of working in changing conditions at all stages of the professional development of a future specialist (from educational practice in the 1st year to residency training). One of the areas of such work is the management of the adaptation of new medical personnel to professional activities.

In its most general form, professional adaptation is the adaptation of a person to new working conditions for him. Along with this, professional adaptation is also understood as a multilateral process of adapting an employee to the content and conditions of work, to the immediate social environment, as well as improving the business and personal qualities of an employee, as a process that requires both the employee and the team to be mutually active and interested in each other. ; and as a way of adapting a professional user, a person directly interacting with the subject environment, to the subject-spatial environment in which he is forced to realize his labor activity.

Despite the diversity of interpretations of the concept of "professional adaptation", researchers agree that it is during this period that the newcomer's attitude to the team and the organization as a whole is laid, and the motivation for work in a new place is formed. The effectiveness of professional adaptation depends on the productivity of subsequent activities, the mental and psychological health of the employee, the quality of medical care provided to patients.

A feature of the professional adaptation of graduates of medical universities is that the inclusion in the professional activities of a doctor occurs already at the stage of training in internship and residency, i.e. before starting independent work in medical organizations as a certified and certified employee.

Internship and residency are a mandatory form of professional training for persons who have mastered the educational programs of higher medical and pharmaceutical education, and serve as the basis for them to occupy relevant positions in health care institutions of the state, municipal and private health care systems.

Residency, as part of the multi-level structure of higher medical education in Russia, a form of continuing professional education of doctors in higher medical educational institutions, is designed to create conditions for students to acquire the necessary level of knowledge, skills and abilities for their professional activities, as well as qualifications that allow them to occupy certain medical positions. and pharmaceutical workers Regulations on the procedure for organizing and implementing educational activities for educational programs of higher education - residency programs at the SBEI HPE Orgmu of the Ministry of Health of Russia [Electronic resource]. - Access mode: http://www.orgma.ru/internu-i-ordinatoru/ordinatoru/normativnyedokumenty.html, free (date of access: 03/01/2016)..

Along with improving theoretical and practical skills, increasing the degree of independence in professional activities in their chosen specialty, interns and residents need to adapt to a medical organization, adopt the rules dictated by its specifics and mode of work, established traditions and interpersonal relationships. It can be extremely difficult for a future specialist to deal with the inner life of a health care facility on his own: learning everything from his own experience, he spends a fairly large amount of time on this, being distracted from the primary tasks of professional development and improvement.

In such situations, for interns and residents, the support of the immediate supervisor from the medical institution is important, which includes both a discussion of the directions, main tasks and requirements for the doctor's activities, and the study of his proposals and questions. Unfortunately, the latter aspects are the least represented in the system of professional adaptation of interns and residents. As a rule, the introduction of a future doctor is limited to his presentation by the chief physician (head of department) to the staff of the structural unit, without considering his wishes and without providing an opportunity for self-presentation.

Based on the idea of ​​professional adaptation as a process by which an individual, on the one hand, satisfies your needs and expectations imposed on the profession and the conditions for its implementation, and, on the other hand, meets the requirements that apply to it the structure and content of the activity, the social groups in which this professional activity takes place, sufficient attention should be paid to the study of the expectations of interns and residents from interaction and joint activities with the immediate supervisor from the health facility. A quantitative and qualitative analysis of the results obtained in the course of such studies will allow medical universities, together with medical institutions, to foresee possible difficulties for graduates at these stages of professional training, and will also create a basis for developing a set of measures to manage the professional adaptation of future doctors to work.

The stated provisions served as the basis for conducting our own experimental study of the expectations of interns and residents from the activities and personality of the leader in the process of professional adaptation. The study was conducted on the basis of SBEE HPE "Orenburg State Medical University" of the Ministry of Health of the Russian Federation (hereinafter OrSMU) in the 2014-2015 academic year. The study sample consisted of interns and residencies of various specialties with a total number of 188 people (118 interns, 70 residents), including 44 boys and 144 girls. The average age is 24.2 years.

The questionnaire of graduate R.V. Gurina, which is based on the notion of the presence of consistency in the needs of the individual with the requirements for a certain activity, on the relationship between adaptation and the realization of the expectations of a person who finds himself in new conditions [ibid, p. 83].

The questionnaire included four blocks: 1) general information about the graduate; 2) assessment of the level of psychological comfort (well-being) in the process of adaptation; 3) a study of expectations from the personality and activities of the head of the enterprise (in our case, the head of the internship / residency on the basis of a healthcare facility, then - the immediate supervisor from a healthcare facility); 4) study of expectations from the production process (internship / residency) and from oneself in this process.

Guided by the problem stated in the publication, let us dwell on the analysis of the results of the first and third blocks.

The results obtained in the block "Assessment of the level of psychological comfort (well-being) in the process of adaptation" showed the successful nature of the professional adaptation of interns and residents. The level of psychological comfort was assessed positively by 86% of the subjects (+1 - 27%; +2 - 37%; +3 - 22%). More than 50% of respondents adapted to the health care facility in 1 month (52%), assessing the working conditions of their workplace (lighting, cleanliness, noise level, etc.) as satisfactory (47%) and good (46%). Slightly more than 60% of young men and women (64%) carried out their duties in health care facilities with enthusiasm, calmness and concentration, experiencing satisfaction with themselves (95%) and their professional activities in the team of this institution (74%). Only in some cases, the respondents noted physical fatigue (51%) and emotional stress (43%), which do not have a significant impact on the overall positive background of professional activity.

In the third block of the methodology, young men and women were asked to choose from the proposed list of professional and personal qualities and functional duties of the immediate supervisor from the health care facility several answers: no more than 8 options in the first case and no more than 4 in the second. At the same time, we asked the respondents to indicate who was their immediate supervisor from the health facility: the head physician, the head of the department, or a qualified specialist in the chosen specialty. Unfortunately, not all interns and residents were ready to answer this question, from which we can indirectly conclude that in most cases these were chief doctors or department heads. We are inclined to explain the refusal to give an answer by distrust of the anonymity of the survey and possible, exclusively in the views of graduates, negative consequences both in the process of passing the considered forms of vocational education, and in the process of subsequent full-fledged employment in this healthcare facility.

The results of data processing of the block "Study of expectations from the personality and activities of the immediate supervisor from the health facility" are presented in tables 1 and 2.

The results of the survey show that the individual expectations of interns and residents from the personality and activities of the immediate supervisor from the health facility in the process of their professional adaptation are statistically significantly different (statistical processing was carried out using the multifunctional criterion of the z-Fisher angular transformation).

As Table 1 shows, the respondents, first of all, expected to see such professionally significant qualities as a deep knowledge of the field of activity (81.4%), the ability to explain well, to convey knowledge to everyone (75% ), professional competence as the ability and willingness to solve professional problems (60.6%). And if in the latter case the degree of discrepancy between expectations and their implementation is insignificant (differences are not significant), then in the first two it manifests itself more clearly (72.3% and 53.2%, respectively), reaching the level of static significance (p = 2.10 at p ?0.005 and p=4.44 at p?0.001). Consequently, not all graduates were able to realize the needs at the beginning of their internship and residency in a knowledgeable and methodically competent leader.

Table 1 Correlation of expectations from the personality of the immediate supervisor from the health facility and their practical implementation by interns and residents in the process of professional adaptation (in %) (compiled by the authors)

Answer options			c-Fischer p-level
1. Deep knowledge of the field of activity			2.10 p?0.05
2. Methodical skill: the ability to explain well, to convey knowledge to everyone
Answer options	Leadership expectations	Realization of expectations from the personality of the leader	c-Fischer p-level
3. Erudite, broad-minded
5. Kindness, sincerity
6. Sociability
7. Demanding, rigor
8. Understanding workers
9. Fairness, equal treatment for all
10. Conscientiousness, responsibility
11. Caring: guardianship, willingness to help in work, other matters, personal problems
12. Tolerance (tolerance), forgivingness
13. Discipline, punctuality
14. Sense of humor
15. Honesty, truthfulness
16. Passion for one's work, love for one's profession
17. Professional competence (ability and readiness to solve professional problems)
18. Creativity, creativity
19. Entrepreneurship, pragmatism
20. Selflessness, altruism
21. Patriotism (love for the Motherland, pride in the achievements of domestic science and production)
22. Other

According to the subjects, the direct supervisors of internships and residencies from health care facilities lack such personal qualities as understanding of employees (45.7% vs. all (57.4% versus 38.8%; p=3.62 at p?0.001), conscientiousness and responsibility (37.8% versus 28.7%; p=1.87 at p?0.05), tolerance and forbearance (33% versus 22.3%; p=2.32 at p?0.01). However, at the same time, as Table 1 shows, managers from health care facilities turned out to be more patriotic (2.7% vs. 10.6%; u=3.22 at p? 30.8%; p=1.98 at p?0.05).

Otherwise, the expectations of interns and residents, which were realized in the process of professional adaptation with insignificant differences, reveal to us the immediate supervisors from the hospitals as people who love their profession and are passionate about it, sociable, disciplined and punctual, moderately demanding and strict, honest and truthful, with excellent sense of humor, broad outlook and erudition, creativity and creativity. Against the background of the demonstrated positive qualities, however, the fact of a statistical trend towards an increase in entrepreneurship and pragmatism of healthcare professionals (c=1.33 at p?0.1) with a decrease in kindness and sincerity (c=1.30 at p?0) deserves attention. ,1), care, readiness to help others in work, personal problems and other matters (p=1.34 at p?0.1).

A similar situation of discrepancy between the existing expectations and their practical implementation manifested itself in the processing of data on the activities of the immediate supervisor from the health facility for interns and residents (Table 2).

table 2

The ratio of expectations from the activities of the immediate supervisor from the health facility and their practical implementation among interns and residents in the process of professional adaptation (in%) (compiled by the authors)

Answer options	Leadership expectations	Implementation of expectations from the activities of the leader	c-Fischer p-level
1. Assistance in the development of professional activities
2. Facilitating my career advancement
3. Recognition of my abilities, knowledge, skills
4. Creating a healthy psychological climate in the team
5. Solving formal issues, nothing more
6. Providing employees with freedom in their creativity, relationships, communication
7. Resolution of industrial and personal conflicts
8. High salary of employees
9. Organization of interesting events
10. Allowing freedom in my actions
11. Control over my activities
12. I don't expect anything
13. Other

First of all, the moment of a kind of "disappointment" in the profession from the point of view of its material security is obvious: the expectations of 45.2% of interns and residents in the high wages of employees of health facilities were realized only in 9% of cases (p = 8.39 at p? 0.001) . In our opinion, the results obtained are a reflection of the socio-economic and financial situation that has developed in the healthcare system, which, among other things, determines the outflow of young personnel from budgetary medical and preventive organizations.

Starting to improve professional knowledge, skills and abilities in the internship / residency, the graduates of the OSMU hoped to receive assistance in mastering professional activities (84.6%), work to create a healthy psychological climate in the team (66.5 %), assistance in moving up the career ladder (33.%), recognition of their abilities, knowledge and skills (33%). In reality, the situation turned out to be somewhat different. On the one hand, managers from health care facilities generally recognize the abilities, knowledge and skills that students have (32%; q = 0.20 at p? 0.1), but they are mainly involved in solving formal issues (7.4% versus 23, 4%; p=4.44 at p?0.001), resolve industrial and personal conflicts, not paying due attention to maintaining a psychologically healthy atmosphere in the team (46.3%; p=3.97 at p?0.001), mastering by future doctors professional activities (74%; p=2.55 at p?0.01) and their career advancement (18.6%; p=3.31 at p?0.001).

In our opinion, the results obtained should not be interpreted solely as an indicator of the fact that interns and residents are left to themselves in the process of professional adaptation in health facilities. The practical implementation of some expectations clearly illustrates certain specifics. In particular, counting on a rather serious "custodial" activity of an experienced specialist, only 8.5% of the respondents expected to see freedom in their own actions from an experienced specialist. In reality, these expectations were realized only by a small number of boys and girls (10.6%). Therefore, it can be assumed that most of the respondents were under the close attention of the manager who oversees the professional development of the future doctor directly at the health facility, which was confirmed by comparing the expectations and their implementation in relation to monitoring the activities of the intern/resident. At a statistically significant level of significance, it was found that in the activities of the immediate supervisor from the health facility, control over their activities in the process of professional adaptation was felt by 35.1% of the subjects (vs.

Summarizing the results obtained in the study, the following conclusions can be drawn. The professional adaptation of OrSMU interns and residents is ambiguous. The stated success of adaptation to professional activities on the basis of medical institutions comes into conflict with the unsatisfied needs of graduates from the personality and activities of direct supervisors from health care facilities at these stages of professional education. This contradiction can be a factor that determines partial or complete dissatisfaction with the internship and residency in some of the subjects (43%) in comparison with the initial expectations and experiences. Confirmation/refutation of this hypothesis should be considered as one of the promising directions of the stated problem.

The realization of the expectations of interns and residents from the personality and activities of the direct supervisor from the health facility, in general, confirms the available data that in many healthcare institutions this process is "left by chance", and newly arrived specialists (trainees) are considered a "burden" that interferes well streamlined work process.

The expectations of graduates are concentrated, as a rule, around such professionally significant personality traits of the immediate supervisor from the health facility, which reflect the depth of his professional knowledge and the level of methodological skill. In practice, future doctors are more likely to encounter personally significant qualities of a leader (discipline, punctuality, sense of humor, patriotism), which play an important, but not primary role in solving the goals and tasks that are relevant for interns and residents.

In the activities of the immediate supervisor from the health care facility, the OSMU graduates would prefer to see active assistance in mastering the chosen specialty while recognizing the existing knowledge, skills and abilities. The real process of learning in internship and residency is characterized by a specific feature of the activities of the immediate supervisor from the health care facility: the solution of predominantly formal issues with a pronounced control over the activities of the future specialist. On the one hand, this indicates that the professional adaptation of interns and residents is not a spontaneous process, but a process organized, coordinated and managed by the immediate supervisor. On the other hand, it should be borne in mind: what do managers and graduates invest in the concept of "control over my activities"? If we assume that for a manager, control is, first of all, a mandatory daily report by an intern/resident on the work done during the day with a dry analysis of the pros and cons, and for a graduate, it is exclusively total observation and supervision of each step in the absence of much-needed methodological assistance and support, then the explanation of the discovered fact becomes obvious.

Moreover, the statistically significant differences identified in the course of the study between the expectations and their practical implementation among OSMU graduates both from the individual and from the activities of the immediate supervisor from the health care facility may also indicate discrepancies in the ideas about the functional responsibilities of all subjects of professional adaptation in the process of training in internship and residency.

Leveling such situations, in our opinion, can be facilitated, firstly, by familiarizing the direct supervisors of internships and residencies from healthcare facilities with the expectations of young professionals regarding their professional activities and professional and personal qualities. The leading format of such acquaintance should be direct meetings of graduates with leaders, the dialogical form of which will allow clarifying and concretizing the professional and personal expectations of both parties.

Secondly, the development of a system of adaptation measures by the medical and preventive institution, in which the activities of the manager will be distinguished by a clear sequence of steps from the initial acquaintance with the graduate to assessing the success of professional adaptation, preparing a report and a detailed description of the intern/resident.

Thirdly, increased attention to the institution of mentoring in the training of interns / residents. A mentor, as the most experienced specialist, an employee of a medical institution can provide significant assistance in informing graduates of medical universities, creating the necessary conditions for their work, planning and organizing professional development during their internship and residency training, advising on emerging issues, existing difficulties and experiences.

We believe that both sides of interaction will benefit from the introduction of a set of such measures: a medical institution represented by a leader will receive a specialist with the necessary qualifications, and an educational institution (medical university) will be able to significantly increase its prestige and authority by training a specialist who is in demand on the labor market and who successfully adapts and a developing professional.

Literature

1. Aituganov, I.M. Practical training: interaction between the university and the enterprise / I.M. Aituganov, E.A. Korchagin, R.S. Safin // Higher education in Russia. - 2012. - No. 3. - S. 163-166.

2. Gurina, R.V. How to measure professional competence? / R.V. Gurina // Higher education in Russia. - 2008. - No. 10. - S. 82-89.

3. Zhdanova, M.G. Modern conditions for the adaptation of a young doctor in a medical organization / M.G. Zhdanova, O.A. Latukha // Medicine and education in Siberia. - 2015. - No. 3. - S. 112-115.

4. Koksharov, A.V. Problems of adaptation of medical specialists in healthcare institutions / A.V. Koksharov // Intelligentsia and the world. - 2013. - No. 14. - S. 97-107.

5. Livshits, Yu.A. Analysis of higher education as an institution of professional socialization (theoretical aspect) / Yu.A. Livshits // Azimuth of Scientific Research: Pedagogy and Psychology. - 2015. - No. 3 (12). - S. 47-52.

6. Melnikova, I.Yu. Features of medical education and the role of a university teacher in the educational process at the present stage / I.Yu. Melnikova, M.G. Romantsov // International Journal of Experimental Education. - 2013. - No. 11. - S. 47-52.

7. 7. Nalchadzhyan, A.A. Psychological adaptation: mechanisms and strategies / A.A. Nalchadzhyan. - 2nd ed., revised. and additional - M.: Eksmo, 2010. - 368 p.

8. Opfer, E.A. Monitoring the requirements of employers as a means of managing the quality of the educational process at the university / E.A. Opfer: autoref. dis. …. cand. ped. Sciences. - Volgograd, 2013. - 28 p.

9. Pankratova, T.B. Network interaction of universities and employment services / T.B. Pankratova, M.P. Palyanov, A.R. Demchenko, V.I. Lebedev // Higher education in Russia. - 2012. - No. 7. - S. 139-148.

10. Dictionaries and encyclopedias at Academician [Electronic resource]. URL: http://dic.academic.ru/dic.nsf/enc3p/139842 (date of access: 02/28/2016).

11. Sopoev, S.A. Adaptation of young specialists in modern Russian organizations / S.A. Sopoev: author's abstract. dis. …. cand. sociological Sciences. - M., 2013. - 26 p.

12. Chernysheva, O.N. Adaptation of a person to a professional subject environment / O.N. Chernysheva // Psychology of adaptation and social environment: modern approaches, problems, prospects / Ed. ed. L.G. Dikaya, A.L. Zhuravlev. - M.: Publishing House "Institute of Psychology of the Russian Academy of Sciences", 2007. - 624 p. - S. 458-480.

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Adaptation of young employees to work in medical and pharmaceutical organizations.

Recruitment and hiring is a rather lengthy process. The management is interested in the fact that the hired employee does not quit after a few months. However, as statistics show, the highest percentage of hired employees leave their place of work during the first three months. The main reason for their departure is the discrepancy between reality and expectations and the difficulty of integrating into a new organization. Helping an employee to successfully integrate into a new organization is the most important task of his manager and HR specialists.

Often a "novice" comes, and his workplace is not prepared, and no one is particularly concerned about this, beginners are given the right to swim out on their own. But since the first impression usually leaves a deep mark, such a procedure can have a long-term negative impact on the employee's motivation and attitude to work.

"Experience" of this kind can often explain the high turnover in the first weeks or months of employment and the reasons why a new employee may feel alienated and take a negative attitude towards the place of work right from the first day of work. If new employees are left to their own devices, then management cannot influence what they accidentally learn and will lose the opportunity to develop a positive attitude towards work and commitment to corporate traditions.

Adaptation procedures are designed to facilitate the entry of new employees into the organization.

In its most general form, adaptation is “the process of adapting an employee to the conditions of the external and internal environment”.

The term "adaptation" is extremely broad and is used in various fields of science. In sociology and psychology, social and production adaptation are distinguished. To a certain extent, these two types of adaptation intersect with each other, but each of them also has independent areas of application: social activity is not limited to production, and production includes technical, biological, and social aspects.

The basis of the problem of social adaptation is the interaction of the individual and the new social environment for him. For the individual, social adaptation is paradoxical in nature: it unfolds as a search activity, flexibly organized under new conditions, the individual's going beyond the limits of the finished final form.

A specific feature of the activity approach is the substantiation of the conscious and active transformation of the surrounding world as a result of activity as a special form of connection between a living organism and the environment.

With the development of the activity approach, the attitude to the concept of adaptation changes significantly. If earlier it was understood as equivalent to the concept of adaptation and practically exhausted it, then subsequently the value of the adaptive principle itself in adaptation has significantly decreased. Passive adaptation is opposed to active influence on the social environment, its transformation. The very activity of influencing the social environment is understood not simply as a physical orientation to it, as a result of which an adaptive effect is achieved.

According to the psychological theory of activity, adaptation leads to a change in the individual in the process of life. In this case, there is not a direct change in the body under the influence of the environment, but mediated by the psyche, i.e. active. And this adaptation is an integral feature of any activity. Fixture, i.e. the activity directed by the individual towards himself, and the activity directed at the transformation of the environment, can exist only in an inseparable unity.

The process and result of a person's active adaptation to the conditions of a new social environment are social adaptation.

The features of the social adaptation of the individual lie in the fact that the entry of a person into the social environment, the assimilation and active reproduction of social ties occurs in the primary team or small group and is associated with a specific type of activity that unites this team or this group.

Thus, the process and result of social adaptation in the labor collective directly depend on the nature and characteristics of the employees' professional activities. Labor adaptation as a social process of mastering a new labor situation by an individual is characterized by the active influence of the individual and the working environment on each other. A person starting a labor activity and a labor collective are adaptive-adapting systems.

The mechanism of social adaptation of a new employee in a professional team is determined by two main components:

Rapprochement of the value orientations of the collective and the adaptant, the assimilation by the latter of group norms, standards, traditions;

Entering the role structure of the team.

However, when entering a job, a person already has certain goals and value orientations of behavior, in accordance with which he makes his demands on the enterprise. In turn, the company also imposes a set of requirements on the employee. Thus, the adaptation of an employee and an enterprise (labor adaptation) is a two-way process between an individual and a new social environment for her.

Thus, the adaptation process is based on the way of assimilation of the goals, values ​​and specific activities of the team, determined by the structure of the needs and motives of the adapting person. The content of this process and its effectiveness are determined by the correspondence of the goals and objectives of the collective activity to the goals of the employee included in the team.

The primary adaptation of young specialists - graduates of universities, colleges - has its own specifics. They, as a rule, have a good store of knowledge, but a complete (or almost complete) lack of practical experience, which affects the effectiveness and duration of their adaptation. On average, the process of adaptation of university graduates takes place within a year.

Introduction to the position begins immediately after the acceptance of the job offer by a preliminary story about the organization, its goals, the nature and characteristics of labor activity, the results and main achievements. If possible, it is desirable to provide the newcomer with general information in the form of brochures, catalogues, etc.

If the organization is large and there are many newly hired, then the induction can be not only individual, but also collective.

Usually it happens with the help of a special orientation course organized by the personnel department of the enterprise. Depending on the nature of the future work, the content of the orientation focuses either on general information (about the organization as a whole) or on special information (about a separate unit).

Normal and pathological human life activity, which is the object of activity of an employee of a healthcare facility, is a contradictory unity of the necessary and random, repetitive and unique, stable and changeable, definite and indefinite. Necessary and repetitive definite in health and disease is reflected in medical science, principles and schemes of diagnostics, treatment, prevention, containing the experience of doctors of many generations. Knowledge of these provisions is important and necessary. Medical activity is characterized by intellectual complexity, monotony, risk and responsibility, moral problems, interpersonal conflicts. Monotony, moral problems and conflicts are often the causes of psychosomatic illnesses of medical workers.

The standard of an employee of a healthcare facility includes: intelligence, dedication to work, attentiveness, a sense of duty, patience, intuition, seriousness, kindness, a sense of humor.

The most significant factors in choosing a health care facility employee are: ways of communicating with the patient; situational communication, the ability to navigate the needs of the patient; understand his attitudes; openness in the process of communication, good diction and accuracy of expressions, which are based on experience, inner freedom and creativity; authority, reputation, appearance. The clothes of an employee of a healthcare facility affect the patient's assessment of such qualities as attentiveness, sincerity, competence, and, in general, the patient's trust in him.

From the standpoint of personnel management, production adaptation is of the greatest interest. It is she who is a tool in solving such a problem as the formation of the required level of productivity and quality of work for a new worker in a shorter time.

The most significant disadvantage of graduates is the lack of experience, and as a result, the possibility of costly mistakes for the company. In this regard, they are not hired for those jobs where the cost of a mistake is high and there is no way to allocate additional time for advanced training and additional training. True, the list of such jobs is not long.

In addition to lack of experience, graduates do not have enough knowledge and skills to obtain the result required by the company. And this requires financial, time and information investments. Due to the lack of skills and abilities of graduates, they require an individual approach, which implies, first of all, a mentoring system. And the mentor needs to create additional motivation on the part of the organization: various forms of material incentives (from memorable gifts to cash prizes) and non-material incentives (diplomas, placing a photo on the “honor board”, etc.). Unfortunately, in some organizations, mentoring is carried out without proper support, reward systems for mentors are not created against the background of an increase in their responsibility and workload, mentoring is left to chance and is poorly directed, coordinated and encouraged by management.

The need for flexible motivation and close attention to the success of university graduates is the next disadvantage of graduates from the point of view of the employer.

Another disadvantage of graduates is the lack of experience in labor discipline. Graduates, as a rule, do not have a well-formed habit of coming to work on time, completing assigned tasks on time, and complying with the corporate code. Managers note that the most "difficult", "uncomfortable" subordinates are found precisely among former graduates who are accustomed to "soft" pedagogical methods of influence and to observing only the most elementary norms of business etiquette.

A significant disadvantage of graduates is the low level of readiness to solve specific practical problems. There is no ability to work for the result (and this means “holding” the goal, finding ways to overcome obstacles on the way to it, showing independence and perseverance). They do not see the relationship between their work and the result (including financial) of the organization's activities, they do not see how other stages and links of the work of the entire enterprise depend on the work entrusted to them.

University graduates lack responsibility. They are focused on themselves, and not on business (free time and pastime in general is more important than the essence of the organization's business).

An unattractive moment for the employer is the possibility of graduates to go on maternity leave in the first year of work, which will entail another search and selection of the right employee for the period of maternity leave.

And finally, it is worth noting that graduates have a longer adaptation period, since the transition from a university to an organization requires a longer adaptation period than a transition from one organization to another.

Recently, leaders of organizations have often noted such a lack of graduates as unreasonable ambition and inadequacy in perceiving oneself as an employee, which manifests itself in inadequate self-esteem, inflated claims of graduates, unrealistic expectations both in terms of salary, and in assessing their work, and in the nature of the work that want to fulfill. The idea that they will immediately earn big money, as a rule, entails a desire to get a job only in a large company and only in a high-paying position. Young and inexperienced graduates immediately apply for leadership positions and the right to decide strategic issues. Such inadequate ambitions are formed in students, including universities (for example, by their attitudes to “train business leaders”), thus striving to increase the educational motivation of students.

Having highlighted the strengths and weaknesses of university graduates, we can assume that the employer is interested in a graduate who has all the listed positive professional qualities and does not have negative qualities. However, surveys of managers show that the professional and business qualities of young professionals may be perceived differently by employers depending on the personnel strategy and policy, as well as on the stage of development of the organization.

At the stage of intensive growth and development, with an entrepreneurial business strategy and an open personnel policy, the lack of initial labor skills of young specialists can be positively perceived by the employer. Under these conditions, the readiness to take risks in the interests of the company, initiative, contact, the ability to set tasks and quickly solve them become valuable qualities of university graduates.

In addition, employers may be interested in young employees who are focused on "ideal" ideas about the future work, especially when these ideas correspond to the organizational culture of the company.

Most companies that are at the stage of stabilization and have reached a certain level of business stability put forward quite stringent requirements for young professionals: experience, professionalism, and knowledge of modern technologies, including information technology. This position is characteristic of companies with a closed personnel policy, for which a university graduate is not suitable due to lack of professional experience.

The fact that graduates are characterized by a longer working period is of interest to stable functioning organizations with a personnel policy in which career planning and implementation of employees plays an important role.

Thus, the characteristic features of young professionals, regardless of the specifics of the development of the organization, allow them to be potentially successful in various companies. The key features for a graduate are his own active or passive position, the model of behavior that he chooses or unconsciously adheres to.

If we talk about the behavior patterns of graduates that determine the level of their activity, then the specialists of recruitment agencies note the following:

• 1) an individual-career model of behavior, which is characterized by the desire to achieve personal success in life. Graduates who choose this model of behavior, as a rule, study and work at the same time. They know that no one owes them anything, and they try to achieve everything on their own. Many companies are interested in such young, active and enterprising people;
• 2) an indefinite model of behavior that is typical for young people who have not decided on their professional life and have not realized what they want, sometimes inadequately assessing their capabilities. Employers lose interest in those candidates who, during an interview, unreasonably overestimate their requirements for future work, or are ready to consider offers for various positions in different fields of activity;
• 3) a non-independent model of behavior characteristic of graduates, in most cases very capable, but not versed in the requirements of the modern labor market, who do not own job search technologies.

Who and how can influence the choice of a model of behavior of graduates that determine the level of their activity? The answer to the first question is obvious. First of all, universities that provide professional training for future specialists and which, on the one hand, act as an intermediary between employers and future young specialists, and on the other hand, implement their own programs to promote student employment.

The university can influence the ratio of active and passive students in relation to their professional career, thereby increasing the number of young specialists who have successfully adapted and realized themselves in their professional activities.

The university's assistance in professional adaptation and professional career of graduates should be variable, depending on the model.

For students who have chosen the first model of behavior, such assistance as concluding contracts with employers in the early stages of training, personal employment of students who have proven themselves through internships, maintaining a database of graduates and vacancies by employers will be useful.

Career guidance, professional counseling for students on employment and resume writing, balanced, targeted training of students for specific enterprises in additional courses and programs will help students with the second behavior model.

For students with the third behavior model, the university can help by collecting data to analyze the demand for specialists and predict the development of the situation on the labor market, selecting applicants for vacancies and organizing personnel interviews, conducting training under agreements and targeted contracts with enterprises and inviting representatives of the enterprise to participate in the protection of course and diploma projects by students, etc.

In the practice of universities, such forms of work as holding "Job Fairs" and "Career Days", organizing "round tables" with employers on the problems of employment of graduates, etc., have positively proven themselves.

The most effective form of activity to promote employment and professional adaptation is the introduction of a special course for senior students of all specialties of the university, the purpose of which is the formation of knowledge, skills and personal readiness for action that contributes to achieving success in a professional career.

In the process of mastering this course, the following tasks are solved:

• - teaching students practical skills and skills of job search, employment and career building;
• - development of skills to determine the most effective ways, means and methods of achieving success in professional and official growth;
• - formation of motivation for career development.

As a result of studying the course, the student should acquire knowledge of:

• - about the real situation in the labor market;
• - about the principles of career planning and management;
• - about possible ways of job search;
• - on the legal aspects of relations with the employer;
• - about the rules of conduct in organizations;

as well as skills:

• - analyze the changes taking place in the labor market and take them into account in their professional activities;
• - plan and control changes in your career;
• - write a resume;
• - evaluate job offers, etc.

Summing up, it should be noted that university graduates represent a very interesting category of labor force for the employer. Their competitive advantages can be successfully applied in many organizations. The key features for a graduate are his own active position, as well as the possession of job search skills and effective employment. In this regard, the university can provide real assistance to a young specialist, acting as an intermediary between employers and future young specialists, and implementing programs to promote the employment of graduates. The training of a competent specialist who is able to quickly adapt to the realities and requirements of the labor market is becoming one of the urgent tasks of higher education.